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Patient Forms

Patient FormsAt My Orthodontist, we strive to provide our patients with the best possible experience from the moment they walk through our doors. In order to maximize your time with us, and get started right away when you arrive for your first orthodontics appointment, please fill out the following appropriate forms at your convenience beforehand, and bring them with you the day of your initial visit.

Online Registration Forms

You may access the following forms to assist us with your care. Please complete and submit the applicable form(s) below prior to your first visit.

*We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.

Printable Forms


Adobe logo *These forms require Adobe Acrobat Reader. Click the Adobe logo to download.

Visit My Orthodontist Soon!

Our practice has nine state-of-the-art offices located in Lawrenceville, West New York, Cherry Hill, Deptford, East Orange, Paterson, Bayonne, and Medford New Jersey, as well as Langhorne, Pennsylvania. We are so happy to welcome you to our practice, whichever office you end up choosing. Please contact us if you have any questions about orthodontics or beginning treatment with us!

My Orthodontist

  • Lawrenceville Office - 3131 Princeton Pike, Bldg. 1A, Suite 101, Lawrenceville, NJ 08648 Phone: (609) 554-5654 Fax: (609) 883-3382
  • West New York Office - 431 59th St., West New York, NJ 07093 Phone: (201) 331-9177 Fax: 201-590-9560
  • Cherry Hill Office - 1940 E. Route 70, Cherry Hill, NJ 08003 Phone: (856) 263-5488 Fax: 856-424-1309
  • Deptford Office - 1800 Clements Bridge Rd., Deptford Township, NJ 08096 Phone: (856) 408-1276 Fax: 856-251-0649
  • East Orange Office - 185 Central Ave., Suite 305, East Orange, NJ 07018 Phone: (973) 601-5996 Fax: 973-672-1005
  • Langhorne, PA Office - 586 Middletown Blvd., Suite C-10, Langhorne, PA 19047 Phone: (215) 515-7314 Fax: 215-750-7848
  • Bayonne Office - 1222 JFK Blvd., Bayonne, NJ 07002 Phone: (201) 355-5799
  • Paterson Office - 1010 Main St. 2nd Floor, Suite 8, Paterson, NJ 07503 Phone: (862) 881-4153
  • Medford Office - 686 Stokes Rd., Medford, NJ 08055 Phone: (609) 643-0708

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